The Painful Truth About Kidney Stone Symptoms: 8 Warning Signs to Watch For

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Kidney stones are nobody's friend. They are exceedingly painful, and they're actually quite common. Kidney stones, if left undiagnosed and untreated, can actually lead to some major complications like overwhelming infection or septic shock. Kidney stones can also lead to kidney failure. Yeah, they're a problem. The tricky thing about kidney stone symptoms is that they can vary greatly from one person to the next and can present in all kinds of different ways. So whether it's flank pain, blood in the urine, or pain in your testicle, it is important that you are able to recognize kidney stone warning signs and symptoms. So, let's talk about it. Today we're going to discuss the painful truth about the symptoms of kidney stones, and I will give you 8 warning signs you should watch out for.

What Is A Kidney Stone?

So what exactly is a kidney stone? Well, it's exactly what it sounds like. It's a rock inside of your kidneys. The other name is nephrolithiasis. Kidney stones are formed usually when you have a supersaturation of particles. So if you have enough particles or substances floating around in your urine, and they stick together, and then stick inside of the kidney, well then they form a small crystal. As other particles and substances flow by in the urine, they stick to that crystal, and then you form a kidney stone.

Types of Kidney Stones

Now, there are different types of kidney stones. 80% of them are made of calcium, usually calcium oxalate. You can also have calcium phosphate stones, struvite stones, uric acid stones, and cystine stones. There are different kinds of kidney stones and they can present with different symptoms, and they can also have many complications.

kidney stone symptoms

Kidney Stone Complications

The potential complications are why it is so important that you're able to recognize the symptoms of kidney stones. Complications may include UTIs or urinary tract infections. You can get an overwhelming infection of the kidneys, or pyelonephritis. It can also lead to an overwhelming infection of the entire body leading to septic shock. You can also get a blockage of flow, or obstruction, that can lead to kidney failure.


8 Kidney Stone Symptoms and What To Watch For

1. Kidney Stone Pain

Pain is the most common symptom of kidney stones. You can get pain in the back, the side, the flank, or pain in the groin. The pain due to kidney stones is for a number of reasons.

Pain Due To Blockage

One, it can be due to blockage. If a kidney stone is large enough, it can cause a backup of urine in the kidney, which can lead to a stretching of the kidney, which is painful. Also, you can get renal colic, and this is a different kind of pain because it comes and goes. It may come and really be strong, like a 10 out of 10, and last for 20 minutes or an hour, and then it may release. And this is what's happening. You have a certain movement in your kidneys and in the ureters, like peristalsis, and there is a contraction, something like a wave. And when you have a wave that tightens, then it can tighten around that kidney stone and cause pain. That's why people will often describe "waves of pain" with kidney stones.

kidney stone pain

The pain can be in the back or the flank, especially if the stone is higher up. And if the kidney stone is a little bit lower, then it can radiate. That pain can radiate from the back all the way down to the groin. And if the kidney stone is a little lower, like in the ureter, that tube that is between the kidneys and the bladder, well you can actually get pain in your testicle, or if you're a lady, can get pain in your labia, and labia means lip (the lip of your vagina).

Diffuse Abdominal Pain

Pain is not always just localized in the flank, on the side, or in the groin.  You can also get diffuse abdominal pain. You can get pain all over the abdomen with kidney stones. Pain caused by kidney stones can be treated with analgesics or pain medicines like the popular Toradol. Make sure that you consult with your physician, or if you have chronic kidney disease, you let the ER doctor know because you may not be able to take that non-steroidal anti-inflammatory drug (NSAID). There are other pain medications that can work. And of course, correcting the underlying problem, and getting rid of the kidney stone is going to be the absolute treatment.

2. Painful Urination

Now, the pain when trying to urinate when you have a kidney stone can come from the kidney stone moving further down as that urine flows past. And if that kidney stone moves to a spot where it's tight, and it starts scraping against the inner portions of your kidney, that can cause pain. Also, as I mentioned, that wave, that peristalsis, that contraction in the kidneys and the ureters as the stone moves can also cause pain while urinating. If you get a complication of a urinary tract infection, then of course, that can cause dysuria, or painful urination as well.

3. Frequent Urge To Urinate

Now, if you have a kidney stone, and it's causing a blockage, then it can give you a sense of fullness in the kidney, or depending on where the stone is located, it can give you a sense of fullness in the ureter or in the bladder. And it can make you feel like you have to urinate. And so you will run to the restroom quite frequently, but you get there and you really can't go, oftentimes, because the stone is blocking the urine.

painful urination

So you may have a fullness. You have the urine that's there, that really needs to get out and wants to get out, but you could have a blocking kidney stone. So that can give you the urinary frequency, and again, if you actually do have a urinary tract infection, well that also can cause the symptom of a frequent urge to urinate.

4. Blood In The Urine, or Hematuria

You can have gross hematuria, which means it's the blood that you can see with the naked eye. Or you can have microscopic hematuria, meaning that you can't see the blood, but when you go to the doctor and they test your urine, they're able to see that red blood cells are there. Hematuria can occur with kidney stones causing the blood in the urine.

Kidney Stones Study Results

There's one study that showed that 10 to 30% of the cases of documented nephrolithiasis, or kidney stones, did have blood in the urine. There's another study that revealed that two out of three people with stones down in the ureter had blood in the urine.

The tricky thing is that sometimes it depends on the timing. Because there has been another study that showed that for patients who presented on day one of the symptoms, 95% had blood in the urine, but of patients who presented on day three or day four, only 65 to 68% had blood in their urine. So it is variable. The blood in the urine is caused by the stones, literally, scraping and scratching the insides of your kidney. They're literally scraping and scratching on their way as they move through the kidney, and this can lead to blood in the urine.

The Way Blood Looks In The Urine Can Vary

Now if you see blood in the urine, you definitely do want to consult with your physician. Now the way the blood looks in the urine can vary. It can be just pink-tinged urine, orange, little drops of blood, or you can get outright bright red blood in the urine. You can just be urinating out blood, and in that case, you definitely want to consult with your physician or go even to the ER. And certainly, if you have symptoms of lightheadedness or if you feel like your heart is having palpitations, this could be a sign that you're losing very significant blood. And again, you want to activate the EMS or call 911 if you have that type of situation. Either way, you want to consult with your physician.

5. Nausea and Vomiting

Now, we know that nausea and vomiting can really be a kind of non-specific symptom, but nausea and vomiting can be your presenting symptom or warning sign of kidney stones. And it could be for a number of reasons. It could be because the pain is so severe that it's causing you to feel nauseated.

It can also be caused if you develop an overwhelming infection because of a kidney stone. If you have sepsis, this can cause you to be nauseated and vomit. The treatment will, again, be treating the underlying kidney stone, and certainly, you can get anti-emetics, or anti-nausea, medicines as well as medicines to control the pain, and antibiotics if you have an infection.

nausea and vomiting

If your nausea and vomiting are so severe that you cannot keep down fluids, you definitely need to go in and see your doctor because you likely will need IV hydration. Being dehydrated will put you at an even greater risk of a kidney stone. Plus, if you're nauseated and vomiting, you're not going to be able to keep down any pain medicines, and it could just be a miserable situation.

6. Fever and Chills

If you have a kidney stone and it has caused a blockage or a backup of urine in your kidney, you can certainly get a urinary tract infection. And the urinary tract infection may start off being in the kidney or even in the bladder, but then it can lead to sepsis, or an overwhelming infection, that can make you very sick and give you fever and chills. If you have pyelonephritis or an infection in the kidneys, that can cause a fever and chills as well. You definitely want to go in to see your doctor. You need to have your urine tested, and you need to have your blood tested for an infection as well. They can treat you, depending on what they find, with antibiotics, fluids, pain management, and with nausea medication if necessary.

7. Foul Smelling Urine

Now, y'all know this is a problem. The urine can be cloudy if you have a kidney stone for a couple of reasons. One, if you're actually passing bits of the kidney stone, or if you're passing something like gravel in the urine, the presence of the stones can cause the urine to look cloudy. But if you have foul-smelling urine, then you likely have developed the complication of a urinary tract infection. Again, you definitely want to go in to visit your doctor or visit the emergency room. You want your urine to be tested, the blood to be tested if necessary, and you want to have antibiotics given.

8. Difficulty Passing Urine

Difficulty passing urine, or just inability for the urine to pass at all, now this is a problem. This is an emergency. If you're having difficulty passing your urine, then it likely means that the kidney stone has caused an obstruction or a blockage. And if you have a blockage in your kidneys to the point where you can't pass urine, this can definitely lead to a backup of urine that causes pressure inside of the kidneys, or hydronephrosis, and it can lead to kidney failure. And it can lead to kidney failure very quickly.

  • If you're not able to pass urine, you will need to visit the ER

    So if you're not able to pass urine, you likely have obstruction or blockage, and you need to go to the emergency room. They will evaluate you there. They'll do imaging and all of the things to check you out for kidney stones. Most importantly, they can relieve the obstruction or blockage. It may be as simple as them placing a Foley catheter, or a urine catheter to see if they can bypass where a stone is. Or they may need to consult with a urologist who may need to put a scope in you, a cystoscopy, where they actually take a camera and a light and go in and look and see.


  • A urologist will be able to access your situation and answer more questions

    They will be able to answer questions like, is the stone in the ureter? Is the stone a little bit higher up? Is it a bladder stone? And they're able to retrieve the stone and remove it that way. If that's not enough to remove the stone, there are other procedures like lithotripsy where the urologist can actually use shock waves to break up the stone. And if it's even more complicated than that, like for example, if you have one of these large struvite stones, the magnesium, ammonium, or phosphate stones, they may actually have to do an open procedure. They can often do it laparoscopically, but a urology consult would be in order if you have an obstruction that a Foley catheter can't relieve.


It is important to detect kidney stones and kidney stone symptoms early to be sure that you try to avoid some of the complications like obstruction, sepsis, and kidney failure. Kidney stones in many cases can also be prevented. If you're someone who's already had a kidney stone, then there's a great chance that you will have another kidney stone unless you prevent it. And you can prevent it by drinking a lot of water and by actually having your urine analyzed to find out what substances or particles are causing your kidney stones. The gold standard for diagnosing kidney stones is a CT scan with low radiation and no contrast. Kidney ultrasounds and radiography can be used as well, when needed, especially in pregnant ladies. If you found this article to be helpful and informative, please be sure to like it and share it with the people you care about. Please, do your best to live your healthiest, happiest life.

Dr. Frita - Frita McRae Fisher, M.D.
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